Relationship of renal size, body size, and blood pressure in children
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Clinical nephrology Original article
Relationship of renal size, body size, and blood pressure in children Pascale H. Lane1, Craig W. Belsha2, Jona Plummer2, George F. Steinhardt3, Robert E. Lynch1, and Ellen G. Wood1 Department of Pediatrics, Saint Louis University, St. Louis, Missouri, USA Department of Pediatrics, University of Arkansas, Little Rock, Arkansas, USA 3 Department of Surgery, Saint Louis University, St. Louis, Missouri, USA 1 2
Received April 22, 1997; received in revised form and accepted July 23, 1997
Abstract. Somatometric parameters, renal size, and systolic blood pressure (SBP) were studied in 406 patients referred to pediatric nephrology and urology clinics. These patients included 269 females (66%), 67 African Americans (17%), and 87 patients with essential hypertension (21%). Z scores for the study population were comparable to published standards for height, kidney length, and SBP. Weight and body mass index scores were significantly greater than predicted from the standards, especially in the subset of patients with essential hypertension. Age, height, weight, body mass index, kidney length, and SBP all correlated with one another; however, on multiple regression analysis of SBP with the other five independent variables, only weight proved to have a significant correlation. Furthermore, the relationship of kidney length with SBP was positive and hypertensive patients had greater kidney size than published standards. These data do not support reduced kidney size in the population with essential hypertension, nor is there support for a convincing correlation between kidney length and SBP in the general pediatric population. Body weight correlates best with blood pressure. These findings warrant further study in a less-select population. Prevention and treatment of obesity may thus be of prime importance in addressing hypertension in children. Key words:mKidney length ± Body weight ± Body mass index ± Systolic blood pressure ± Obesity ± Hypertension Introduction Hypertensive nephropathy causes end-stage renal disease (ESRD) in 28.5% of all new patients entering treatment programs in the United States [1]. African Americans in particular develop a disproportionate amount of this ESRD Correspondence to: P. H. Lane, Department of Pediatric Nephrology, Cardinal Glennon Children's Hospital, 1465 S Grand Boulevard, St. Louis, MO 63 104, USA
due to hypertension [1 ± 3]. In the Multiple Risk Factors Intervention Trial, antihypertensive treatment slowed progression of proteinuria in Caucasians with elevated blood pressure. Identical treatment in African Americans failed to retard the renal complications of hypertension [4]. The factors that lead to primary (essential) hypertension and promote nephrosclerosis in certain hypertensive individuals, especially those of African heritage, are unclear. Identification of such risk factors could reduce the risk of ESRD, particularly in the African American population. One factor that may lead to primary hypertension and nephrosclerosis is congenitally reduced
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